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Home > Getting Well and Staying Well > Living Well Despite Illness

Evidence of a Mind-Body Connection

"The ancient idea that attitudes play a vital part in the recovery process is finding systematic verification in current medical research. . . There is little doubt about the fact that fear is a great accelerator of disease. Conversely, hope, faith, confidence and the will to live set an auspicious stage for efforts toward recovery."

— Norman Cousins, Former Editor, Saturday Review of Literature

One of the most fascinating observations of the mind-body correlation was first noticed more than a decade ago. Some multiple personalities who were allergic to strawberries or exhibited symptoms of insulin-dependent diabetes when expressing one personality did not have those physical problems when in another personality state — entirely different reactions within the same body!

Then there is the famous "placebo response," which is just another way of saying that some people get better simply because they believe will get better. One of the most frequently cited clinical cases is that of a patient with lymphosarcoma. His condition, thought to be pre-terminal, went into remission almost totally for two months while he was receiving injections of Krebiozen, an experimental drug he thought would cure him. After learning from the news that the drug was useless, he relapsed. His physician cleverly reactivated the patient's faith in the medication by giving him water injections that were described as a refined and more potent form of the same drug. The patient once again recovered, only to relapse and die several months later after discovering from a nationwide announcement that Krebiozen had no therapeutic value.

Today there are many researchers trying to see just how our thoughts, attitudes, beliefs, emotions and health affect each other. In fact, scientists have even developed a new branch of medicine to explore the link between emotions and the immune system. Then, as scientists are prone to do, they gave this new field a long name — psychoneuroimmunology — although in medicine's love of acronyms, they frequently shorten it to PNI.

More easily remembered terms for this relationship are mind-body, (and the variations of mindbody, mind/body, and bodymind) and mind-body-spirit, since there is another dimension to the relationships between health and the total person. In fact, since we humans are physical, mental, social, emotional, AND spiritual beings, some people refer to a "physical - emotional - social - psychological - spiritual" relationship.

Two Studies on the Effect of Fighting Spirit and Hopelessness

Cancer is often used in research that looks at the relationship of mind and body because so many statistics are known about the probability of survival for different kinds of treatment, making it easier to determine whether an improvement was the result of a new chemotherapy or of attitude. Although we can't extrapolate results to all other diseases, since the relationship of emotions and mind might work differently for different physical conditions, it does seem reasonable to assume that if there is a strong correlation between cancer and emotions, the same would probably be true for other diseases.

In any case, the role that attitude plays in prognosis of illness has been evaluated in two studies of women with breast cancer.

One study was conducted by Steven Greer and reported in several sources, such as The Type C Connection by Lydia Temoshok and Henry Dreher. He interviewed women three months after they had mastectomies and divided them into four groups according to their psychological coping style: (1) those with a "fighting spirit" who accepted the diagnosis, adopted an optimistic attitude, sought information and were determined to fight the disease, (2) the "positive avoiders" who either rejected the diagnosis or minimized its seriousness, (3) the "stoics" who accepted the diagnosis but did not seek further information and adopted a fatalistic attitude, and (4) the "helpless and hopeless" whose lives were preoccupied with cancer and dying.

At the end of five years, only 20% of the "helpless and hopeless" group were alive and disease free. This compared with 32% of the "stoics", 70% of the "positive avoiders" and a full 80% of the "fighting spirit" group. A 10-year follow-up indicated that a "fighting spirit" was still significantly associated with a better prognosis.

This seemed to give credence to the idea that if you can simply be positive enough all the time and keep up your spirits, you could beat your cancer primarily with your mind. This mind-over-matter approach caused a great deal of grief for cancer patients who couldn't always be upbeat.

Then, more recently, a similar study was done in England with a larger group of women that measured patients' attitudes toward their cancer, scoring the women in several categories, including fighting spirit, helplessness / hopelessness, anxiety and depression. The results, published in the Oct. 16, 1999, issue of the British journal The Lancet found that a fighting spirit had no effect on survival, although feeling helpless and hopeless can reduce long-term survival, especially if women don't get treatment for their feelings.

The effect from feeling helpless and hopeless "was very modest but not trivial." Of women who felt helpless and hopeless, Watson says. "58 percent were alive or in remission five years after diagnosis. Of women who were not helpless or hopeless, 72 percent were alive or in remission five years after diagnosis. . . . [Further,] women who scored high on the depression scale were 3.5 times more likely to have a relapse or die within five years than those who weren't depressed. Those who scored high on the hopelessness scale were 1.5 times more likely to die or have a relapse as those who scored low in that category."

Maggie Watson, the consultant clinical psychologist at Royal Marsden Hospital in London who headed up the study, points out "two messages" women can take from this study. "The first is that women who find it difficult to be combative, to maintain a fighting spirit all the time, don't have to feel" the pressure of always being positive, which can remove their burden of guilt. "The other message is that feeling helpless and hopeless may be a symptom of depression."

Therefore, it's very important that doctors recommend treatment for depression, including counseling and perhaps anti-depressant medication to help improve the chances for survival — and at the very least to help these patients improve their emotional well-being.

© Copyright 1995, Revised 2002, Arlene Harder, MA, MFT

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DAILY SURVIVAL KIT FOR SERIOUS ILLNESSES

You don't have to agree with all of this all of the time. But, if it generally speaks to you, try to read all or parts of it everyday, or have it read to you. Part of the help is in the doing, regardless of your attitude or emotions on that day. On some levels the help is gradual and often not evident.

1. Today I am going to try to live through this day only, and not dwell on or attempt to solve all my problems at once; just focus on the piece that is today. I can do something for several hours that would be difficult to even think about continuing for several months.

2. Just for today, I am willing to accept the possibility that there is a purpose to this suffering; that it can be a source of meaning and growth for myself and others, though I may not always recognize the ways. And it seems possible that this suffering will not be in vain, because of what may be some kind of existence beyond.

3. Just for today, let me remind myself that I am basically a worthwhile person, worth loving, despite my faults and limits. I deserve the efforts of others to help me through my illness.

4. Just for today, I want to be aware that it is all right to want too much from others at times. Illness brings out and intensifies the small child in all of us. And if I feel hurt when those who care for me cannot be there, it may help to remember that they have needs, frailties, and limitations of their own. A lack of response does not mean that they are personally rejecting me.

5. Today I may feel the need to complain a great deal; I may have little tolerance; I may cry; I may scream. That does not mean that I am less courageous or strong. All are ways of expressing anger over this mess, of rightly mourning my losses. Endurance itself is courage.

6. It is my life at stake now. So maybe today I can allow myself to be a little less concerned about the reactions or impressions of others. Maybe I can allow myself to feel a little less guilty or bad about what I did not accomplish or give. Perhaps today I can be a little more gentle toward myself.

7. Surviving this is all so difficult. At times it seems impossible - that I have had enough. Down the line I will know if and when I have had enough, when I cannot push the limits any further. I will have the right to choose to stop, without feeling that I am "giving up." But today I think I can deal with this illness. Sorrow runs very deep, but I think I can rise again.

8. Just for today, maybe I can give healing "the benefit of the doubt." The drugs are powerful; the natural healing capacity of my body is powerful. And who knows, perhaps there is healing power in my will to struggle, and in the collective love and will of others.

9. Just for today, perhaps I can take heart that we are all connected. And I may still have some things left to contribute to the family of man; some light to add to the light. Even now my endurance (however imperfect) is a gift, an inspiration for others in their struggles.

10. It seems reasonable that there is a season for everything, and a time for every purpose. Pain, weakness, and exhaustion may distort my senses and spirit. Today, however, I can at least find some hope in nature's way, if not in some master plan. The chances are fairly good, and it seems worthwhile to hope, that I will have some cycle of wellness yet.

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